COVID triage. It's seniors' turn to die

      "A man can die but once. We owe God a death, and let it go which way it will, he that dies this year is quit for the next."

              Henry IV, Part 2  William Shakespeare

The USA has a policy of sacrificing old, sick people in order to spare the young and the economy. We just don't want to admit it.

Let me be clear. I am not happy about this. I am 71 years old.  I am on the hit list. I am not advocating. I am describing.

A Great Barrington Declaration is circulating and adding signatures. It advocates a change in US policies away from mass virus suppression and toward "Focused Protection." The Declaration says that it is both impossible and morally wrong to burden the entire country with the effort to stop the spread of the virus. COVID is probably not very dangerous for most Americans, it says, so the entire effort should be to protect the people that COVID actually endangers, the old and the sick. The cost of attempting to protect everyone is too great and the net result is more harm than good. Yes, people are going to get hurt, but fewer people are hurt if we stop trying to protect people who don't need protection and focus on those who do. www.gbdeclaration.org

The ethic of Utilitarianism is well known among students who have taken a college course in philosophy. Jeremy Bentham, 1748-1832, put the idea of Utilitarianism into coherent form. How to weigh the various moral consequences of any action? The best answer, he said, is summarized by a phrase: Do the greatest good for the greatest number.

The Great Barrington Declaration takes note of the reality that the social distancing rules have costs. Protecting seniors and the sick mean millions of schoolchildren are missing school and therefore education essential to their futures. It means millions of people who want to work cannot. It is disrupting landlord/tenant relations. It is pushing people into poverty, with all of poverty's current and long term consequences. It is exacerbating the problems of inequality, since many of the people least able to adjust to the new regimen are people already experiencing inequality, the working poor and their children.



Meanwhile, the people who could best be able to deal with social distancing and economic slowdowns are most likely to be out of the workforce, people getting pension and Social Security checks. They can shelter and protect themselves.

The Utilitarian idea focuses on the whole. By contrast, the Golden Rule ethic focuses on individual feelings, asking people how they would want to be treated, and few people would ask to be injured. The Golden Rule may work for guiding ones behavior toward family and neighbor, but for a national leader, it causes one to "err" on the side of compassion and avoiding direct injury.The Golden Rule is the ethical basis underlying policy of mass reduction of COVID spread, and the position advanced by Democrats. Look at the dead and injured. Think of them and their families. Don't hurt more people.

In actual practice, Americans have given up on mass suppression of COVID. Trump was certainly motivated by his re-election and maintaining a facade of COVID being harmless to protect the strong economy, but the result is that he backed into a Utilitarian policy of triage that sacrifices the old and sick for the benefit of the young, the healthy, and the economy.

He had choices. A mass COVID suppression program could have worked, with early and consistent buy-in from national leadership, with mask wearing, social distancing, shut-downs of social gatherings including church services and schools, plus testing and aggressive contact tracing. All those actions needed to have been affirmed as patriotic at the highest levels of government. There needed to be bipartisan buy-in. That didn't happen. A mass stop-the-spread policy cannot work if 35-40% of people think it is foolish and an affront to liberty and personal choice and a partisan signal of defeat to the opposite Party.

Trump is hinting at the actual policy with his I-feel-great comments and his unapologetic events that risk virus spread. White House behavior is body language messaging. "Don't let the virus dominate you," Trump says, in word and deed. But he is not laying out the actual policy because he is offering the fig leaf of it being non-fatal, there being therapies, and an imminent vaccine.

The simple reality is that as more people get virus, some percentage of extra people will die, concentrated among the old and unwell. It is politically unappealing to focus on the deaths, not the benefit to the people who continue to go to school and to work. Seniors vote, and there are a lot of seniors in Florida and Arizona, two states that Trump must win to be re-elected. If it were openly acknowledged that a half million seniors needed to die a just a few years early for the good of their fellow Americans, then people would be facing an ugly reality. 

Americans eat meat, but they avert their eyes to the actions that take place in slaughterhouses. Some work gets done because people focus on the sirloin, not the death and dismemberment of the cow.

Trump says our COVID policy is about the injury from China, and about freedom and resisting Democratic governors, and not being over-cautious since great therapies and a vaccine are coming soon, and besides Dr. Fauci is probably a Democrat and there are second opinions that differ from his. Republican seniors in Florida and Arizona have that fig leaf to hold onto.

The reality is that the floodgates are opening and we hit a new high of infections yesterday. It is too late to stop mass spread. If Biden loses the election it will be because people realized that they disliked the COVID-related shutdown more than they hated Trump's tweets, and that if Biden were president it would mean more months of inconvenience, but if Trump were elected things would go back to normal.

"Normal" means that young people go to school, that workers go back to work, and that old people get sick and die, just like always.